Do you remember when Labour used to scare voters that WE would privatise the NHS?

“Managing NHS hospitals is a complex task. We must ensure the best possible providers run our NHS services – whatever sector they come from. Some of the people best equipped to carry out that task are currently managing successful NHS hospitals. The Government must ensure that successful NHS managers have the same opportunity to take on the management of failing hospitals as private companies. We cannot repeat the situation experienced so often under Labour, where private sector companies are brought in, with all the benefits if things go right, but without the risk of any financial loss being transferred to them if things go wrong.”

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The Labour government is privatising the NHS on an unprecendented scale but what is even more frightening is the absolutely thorough fragmentation of a uniquely holistic service. The Labour grand scheme does not recognise the patient as an integral human being, flagrantly debasing it as a commodity and treating it as an aggregate of components.

The long-term and enduring consequences, if Labour is allowed to pursue its plans unchecked, is a dumbing down of the quality of medical services with reduction of expertise and a resultant health system that will be much more expensive. Health inequalities will widen even more than it is today.

After over 30 years of service in the NHS, I am dismounting to fight this nonsense. It's a real shame that through anger and frustration at the political interference with flawed policies, many of my colleagues who are so dedicated to medicine and who are first-class clinicians are leaving the service through emigration, early retirement or switching out of medicine.

Are we as a nation so stupid to allow a brain drain and skills loss?

Or perhaps, is the decimation of the NHS part of a wider British disease that includes loss of national pride, identity and sovereignty, and now reaching the terminal stages?

Incidentally, I think this is a terrible idea. Bringing in managers from succesful hospitals to turn around existing ones is good, but the private sector don't know what the hell they are doing in this arena. Labour is certainly to the right of me on this, but I imagine you lot approve of this idea, and should be applauding.

Graham Checker (at 11:33), what is badly wrong about the government policy for private sector involvement in health is the scale of change, poor synchronisation of various projects, non-integration of key components, the poor implementation and the lack of consistency between stewardship and outcomes.

Add that to the twin problems of wastage and high costs of the projects.

You need to work in different parts of the NHS to understand the enormity of the difficulties, and how that translates into the gulf between the expectation of improvement and the disappointing realities at the patient level.

Here in parts of the North East nearly 40% of the working age population are not in work - it is a financial burden the rest of us in these parts have to cover in higher council tax etc.

All at a time when the jobs market is supposed to be bouyant!

Please don't reply with any lefty socialist rubbish, it won't wash - I'm the last generation that had an outside tap and a shared outside toilet (I'm early 40's) my father was a tradesman for the Coal Board, both grandfathers worked in the mines, so too 6 uncles toiled the Durham coalfield...and my wife's from one of the hardest council estates around, Tory to the core too.

...and just for the record, statistically, many more collieries closed in Durham under Labour administrations than under Conservatives - so stick that in your pipe for good measure.

Labour has repeatredly failed the working classes, I could write a thesis on it, and boy would I like the opportunity to blast these mealy-mouthed lefties straight to their faces.

@ passing leftie - based on ONS figures, many hundreds of thousands of people have entered the job market since 1997. It doesn't take a mathematical genius to understand the difference between employment and unemployment. The former is higher than in 1997, and so is the latter.

Just to clarify , the Labour government, headed by a man elected for a seat in another country and with no legitimacy in England since 1997, are imposing this privatising policy only on the English NHS.

( for there are now four quite separate NHS's no matter how some on these threads like to kid themselves that there is still a single British NHS)

It is happening not only at hospital level but also at general practice level in a identifiably two pronged way

Firstly the sale of francises to operate GP surgeries mainly to large companies .This is not only in the traditional areas of poor GP provision ie inner cities - it is spreading to "ordinary" areas. The contractual conditions and reimbursement rates for these centres are kept very quiet but can only be at much higher long term rates than awarded to traditional GP practices.

Secondly, and over lapping, is the setting up of Darzi clinics often in areas of existing very good provision but on a difficult to explain basis. Whatever these eventually become - they might evolve into HMO's - their desirability has never been debated by the representatives of England .

There is perhaps something to be said for greater flexibility of methods of provision but the present democratic basis of doing it is about the same as Ship Money.

As someone who actively administered Labour's so called Welfare To Work policies within the DWP, I can assure you that from Harman and Field onwards, claimants were actively 'encouraged' to move from JSA to IB solely in order to show that unemployment levels were falling under Labour.

You are wrong, Labour came into power in 1997, not 1992, and the JSA count was 1.6m.

Based on the criteria you want to use to count the 'economically inactive', the real figure under Labour in 2008 is 5.5m.

A fitting legacy for Gordon Brown.

Economically inactive includes all of those Millions of claimants that were moved from Unemployed benefit to Invalidity benefit at the rump end of John Majors administration.
The true level of unemployment was way closer to 3 million than the 1.6m you are quoting. Labours record is bad but our record was also pretty shocking as well. When you take account of the increase in population the level of Economical inactive people as a percentage of the population is almost unchanged.

"As someone who actively administered Labour's so called Welfare To Work policies within the DWP, I can assure you that from Harman and Field onwards, claimants were actively 'encouraged' to move from JSA to IB solely in order to show that unemployment levels were falling under Labour.

Civil servants in JCP offices were given targets to this effect."

There; so it was not just John Major's administration that used IB as a dumping ground for many of the long term unemployed. I know a number of people who are on IB who have nothing at all wrong with them. What is really sickening is that there are many people (my wife included) who really are ill and who deserve a better deal.

Andrew Lansley is right, and so was Gerry Robinson.
The NHS is an incredibly complex and mammoth beast that has many contradictions in policy, little joined up thinking and a system that is stacked against some of the more poorly funded areas, not to mention endless bureaucracy.
Gerry Robinson couldn't get past the ludicrous NHS rules and perversities. Good managers can be in "failing" hospitals, and vice versa. Good clinical care is not necessarily reflected in performance measures, either.
What we need is true accountability to patients, not to managers who are not able or too scared to pass back to the Department of Health how perverse some of their policies are. If hospitals were accountable to patients as opposed to a bureaucratic system with anonymous commissoner and provider managers, things would start to improve. Current patient "choice" is so limited that it just doesn't work.

"Britain's National Health Service remains a 'mediocre' provider of healthcare, performing much less well than almost all of the UK's peers in western Europe, according to a European survey."
http://www.guardian.co.uk/international/story/0,,2181427,00.html

"Britain's health system is among the worst in Europe, according to a survey. The poll of all EU member states plus Switzerland and Norway ranks Britain 17th out of 29 countries for patient satisfaction."
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/10/02/nhealth102.xml

Btw "Early in Blair's second term, Gordon Brown announced a five-year programme of record funding to bring health spending up to top European levels. The annual increases of over 7% until 2008 will mean the NHS budget will have tripled since Labour came to power."
http://news.bbc.co.uk/1/hi/health/4555344.stm

Talking of untruths, Hazel Blears also told a quite blatant lie on BBC Question Time about Labour inheriting "3 million unemployed".
I checked the ILO figure - the survey showed 2.087 million people unemployed in May 1997 compared to 1.612 million now, so slightly but not much lower. On the claimant count it looks more spectacular - 1.6 million in May 1997 and 806,300.

Of course some figures do put unemployment higher than the ILO figure, suggesting that unemployment overall is more like 2.25 million, on that figure the 3 million might be correct for 1997, but not so flattering for Labour - she is deliberately playing fast and loose with statistics.

The fact is all governments in my lifetime have been economic with Truth about the true level of unemployment. The trend in recent years has been to switch the long-term unemployed onto long term sickness benefit were ever possible. Which is great in so much as they get a better deal, but is bad because it swells the ranks of the sick with a lot of people who could be in the job market. It also means that the truly sick get less than they should receive in benefit. I know at least three people who are on sickness benefit for "depression" this isn't the serious bio-polar illness which really is a disability, but simple depression. These people would be far better off working but are encouraged to stay out of the work market. The worse thing about this sick note culture is that there are very few checkups made to ensure the claimant is still to sick to work. So a person might well get depressed and then spend the rest of his life claiming IB because frankly it suits the state to pay sickness week in week out rather than invest the sums needed to get these people back into proper work.
Disability Living Allowance is a far better scheme in so much as the majority of claimants are expected to prove they are still ill every 3 or 4 years, so this benefit is better targeted. I want to see the same if not greater rigor applied to IB.
So if a person is on sickness benefit they should be seen by a doctor at least once a year to ensure the condition has not improved.
The way things are going a person on JSA might get depressed quite properly and be moved to IB but they should not still be there ten years later unless they really are very sick indeed. In which case they should be in receipt of DLA. As it is we should be doing everything possible to ensure that as many disabled people who are able and willing are included in the job market. Frankly if I had been unemployed for two years I would be depressed.

When Gordon Brown took over at the Treasury on 2 May 1997, he and his Team sat through a presentation from senior Treasury civil servants. They confirmed that the economic legacy inherited from Kennneth Clarke was almost totally benign.

By the final quarter of 1995, Britain's ILO unemployment rate - which, btw, is the New Labour preferred measure of unemployment in the form of the quarterly "Labour Force Survey" rather than the claimant count - was lower than in France, Germany or Italy, the other major European economies. And, importantly, Britain's employment rate of working-age people was higher than in France, Germany or Italy.

As the 2.6 million presently on Incapacity Benefit in Britain arguably distort the official unemployment figures - whether of the Labour Force Survey variety or the claimant count - the percentage of the working-age population in employment is a more significant measure of labour force activity than the unemployment rate, which public debate almost invariably zooms in on.

Quite evidently, from the start GB disliked Sir Terry Burns, the permanent secretary in the Treasury and marginalised him by excluding him from meetings and routing internal mail around him. That was all part of what became an evident strategy to politicise the civil service. Sir Nicholas Stern, who was recruited into HMT as Head of the Government Economic Service and to replace Ed Balls as Chief Economic Adviser in HMT, seems to have been allowed only a very brief stint in the job. Apparently, GB didn't take to him either.

"The Labour grand scheme does not recognise the patient as an integral human being, flagrantly debasing it as a commodity and treating it as an aggregate of components."

I absolutely agree, and this tendency is not restricted to the NHS, it permeates all of the Govt's target culture - it fails to recognize processes and concentrates on tasks. Good Soviet economic thinking. I wish you luck.

A lot of the thread is bandying about this figure and that figure. From The Economist:

“The misuse of statistics by politicians, advertisers and the media is turning from a disease into an epidemic,” says Lord Lipsey, who has called a meeting at the House of Lords for March 17th to gauge support for a “Campaign for Real Statistics”.

For the experts among you, has the new UK Statistics Authority, enabled as of 01/04/2008 (yes really that date) started to make a difference to Lord Lipsey's disease? If so can it be turned to retrospective research so that this bandying about of figures becomes more meaningful ie a dispute about a commonly accepted set of figures rather than a dispute about the source of any set of figures?
What has happened